The relationship of peritubular capillary density with glomerular volume and kidney function in living kidney donors.

BACKGROUND: Peritubular capillary rarefaction plays an important role in the progression of chronic kidney disease. Little is known about the relation between peritubular capillary density, glomerular volume and filtration rate in the healthy kidney. METHODS: In this single-center study, we included 69 living kidney donors who donated between 2005 and 2008 and had representative renal biopsies available. In all donors, glomerular filtration rate was measured using 125I-Iothalamate before donation and at five years after donation. Before donation, the increase in glomerular filtration rate after dopamine stimulation was measured. Glomerular volume and peritubular capillary density were determined in biopsies taken at the time of transplantation. Pearson's correlation coefficient and linear regression were used to assess relations between parameters. RESULTS: Mean donor age was 52 ± 11 years and mean measured glomerular filtration rate was 119 ± 22 mL/min before donation and 82 ± 15 mL/min at five years after donation. While peritubular capillary density (measured by either number of peritubular capillaries/50,000 µm2 or number of peritubular capillaries/tubule) was not associated with measured glomerular filtration rate before or after donation, number of peritubular capillaries/tubule was associated with the increase in measured glomerular filtration rate after dopamine stimulation (St.ß = 0.33, p = 0.004), and correlated positively with glomerular volume (R = 0.24, p = 0.047). Glomerular volume was associated with unstimulated measured glomerular filtration rate before donation (St.ß = 0.31, p = 0.01) and at five years (St.ß = 0.30, p = 0.01) after donation, independent of age. CONCLUSIONS: In summary, peritubular capillary density was not related to unstimulated kidney function before or after kidney donation, in contrast to glomerular volume. However, number of peritubular capillaries/tubule correlated with the increase in glomerular filtration rate after dopamine stimulation in healthy kidneys, and with glomerular volume. These findings suggest that peritubular capillary density and glomerular volume differentially affect kidney function in healthy living kidney donors.

Components Related to Long-Term Effects in the Intra- and Interpersonal Domains: A Meta-Analysis of Universal School-Based Interventions.

The aims of the present meta-analysis were to (1) examine long-term effects of universal secondary school-based interventions on a broad range of competencies and problems and (2) analyze which intervention components were related to stronger or weaker intervention effects at follow-up. Fifty-four studies of controlled evaluations (283 effect sizes) reporting on 52 unique interventions were included. Long-term intervention effects were significant but small; effect sizes ranged from .08 to .23 in the intrapersonal domain (i.e., subjective psychological functioning) and from .10 to .19 in the interpersonal domain (i.e., social functioning). Intervention components were generally related to effects on specific outcomes. Some components (e.g., group discussions) were even related to both stronger and weaker effects depending on the assessed outcome. Moreover, components associated with long-term effects differed from those associated with short-term effects. Our findings underscore the importance of carefully selecting components to foster long-term development on specific outcomes.PROSPERO registration number: CRD42019137981.

Solid as a rock, flexible as water? Effectiveness of a school-based intervention addressing students' intrapersonal and interpersonal domains.

Students following a preparatory vocational education track seem most in need of an intervention stimulating their competencies and preventing the development of problems in the intrapersonal and interpersonal domain. The aim of the present study was to examine, first, whether Rock & Water, a social emotional learning intervention that uses active forms of learning, is effective in improving students' competencies and preventing problems in the intra- and interpersonal domain, and second, whether intervention effects were influenced by the extent to which multiple systems are involved in the intervention. We conducted a randomized controlled trial with a sample of 7th grade students (N = 1299, Mage = 12.38, 54% boys). Students reported on outcomes of the intra- and interpersonal domains using digital questionnaires. The data were analyzed with Latent Growth Curve models. Results showed that the intervention was most effective when only a core team of teachers was involved in the intervention. The intervention improved several proximal outcomes (i.e., self-control and emotional self-regulation) and distal outcomes in students' intrapersonal and interpersonal domains. The intervention effects were strongest, albeit moderate, in the first year of the intervention. These results show that interventions with an active form of learning and implemented by a core team might be promising interventions for prevocational students, although effort should be put in increasing its effectiveness.

Chronic pain after hand-assisted laparoscopic donor nephrectomy.

BACKGROUND: Data on chronic pain after kidney donation are sparse. The aim of this study was to assess the incidence of chronic pain after hand-assisted laparoscopic nephrectomy. METHODS: Living kidney donors who donated between 2011 and 2017 at the University Medical Centre Groningen were included. All patients underwent hand-assisted laparoscopic donor nephrectomy. Postdonation pain and movement disabilities were assessed using the Carolinas Comfort Scale (CCS) and a visual analogue scale (VAS). The prevalence, severity of pain and the need for analgesics were reported. RESULTS: Some 333 living kidney donors with a mean age of 56 years were included. At a median of 19 (i.q.r. 10-33) months after donation, 82 donors (24·6 per cent) had a CCS score above 0, of which 58 (71 per cent) had a CCS score of at least 2 and 57 (70 per cent) reported movement limitations. Some 110 donors (33·0 per cent) had a VAS score of more than 0. Complaints mainly occurred during bending over (12·3 per cent) and exercising (12·4 per cent). Thirty-two donors (9·7 per cent) required analgesics during follow-up between donation and the time of measurement, and six of 82 (7 per cent) reported chronic inguinal pain. In multivariable analysis, donor age (odds ratio (OR) 0·97, 95 per cent c.i. 0·95 to 0·99; P = 0·020) and length of hospital stay (OR 1·21, 1·01 to 1·51; P = 0·041) were independently associated with chronic pain. CONCLUSION: One-quarter of donors experienced chronic postdonation pain or discomfort, most of which was bothersome. Younger donors and those with a longer postoperative hospital stay had more symptoms.

The effectiveness of Rock and Water in improving students' socio-emotional adjustment and social safety: study protocol for a randomized controlled trial.

BACKGROUND: Students following a low education track have an increased risk for developing problem behaviors. Rock and Water is a widespread, but still poorly evaluated, intervention that aims to improve students' socio-emotional adjustment and social safety. The aims of this study are to evaluate (1) the effectiveness of Rock and Water on socio-emotional adjustment (i.e., psychosocial wellbeing, sexual autonomy, and resilience) and social safety (i.e., perceived social security in the classroom, aggression, and bullying) and to examine (2) moderators and (3) mediators of its effects. METHODS: Schools are randomly assigned into four conditions: 'Light' (a core team of teachers is trained), 'Standard' (a core team of teachers and the whole school team is trained), 'Plus' (a core team of teachers, the whole school team is trained, and parents are involved), or 'Control condition' (Care As Usual). We aim to include 180 7th Grade students in each condition (N = 720) across all waves. A multi-informant (i.e., students, parents, and teachers) approach is used to assess the outcomes (socio-emotional adjustment and social safety), moderators (student, trainer, and parent characteristics) and mediators (self-control, self-reflection, self-esteem, and emotion regulation). Video-observations will be analyzed in a subsample to study the possible mediating effect of changes in deviant and prosocial communication among students on the effect on social safety. DISCUSSION: This project will provide information on the effectiveness of (different levels of school and parental involvement in) Rock and Water, which can be used by schools to decide upon the most efficient way to improve the care for the students. We will be able to shed more light on what works for whom and the working mechanisms of Rock and Water. TRIAL REGISTRATION: Dutch Trial Registration number 6554 , registered on the 3rd of July 2017. The design of this study was approved by the Ethical Committee of the Faculty of Social and Behavioral Sciences of Utrecht University (FETC17-015). This study is financially supported by a grant from The Netherlands Organization for Health Research and Development, grant number 531001106.